关键词: 宫颈病变, CO₂激光治疗, 人乳头状瘤病毒

Abstract: Objective To evaluate the therapeutic efficacy of CO₂ laser treatment in cervical intraepithelial neoplasia grade 2（CIN2）patients. Methods We retrospectively analyzed data from 92 CIN2 patients who underwent CO₂ laser therapy at the institution from November 2021 to October 2023. Postoperative followed-up for 6-12 months,screening with liquid-based cytopathology test（LCT）and high-risk human papilloma virus（HPV）testing. Patients with abnormal results in either test were referred for colposcopy,with biopsy performed to evaluate residual or recurrent squamous intraepithelial lesions. Results Among total of 92 patients,most patients aged 25-45 years old,with a history of induced abortion,had three or more sexual partners,and visited hospital due to cervical lesions,and none of the patients gave birth. All patients were found to be HPV positive at hospital visits,with 20. 65% of HPV16 positive,1. 09% of HPV18 positive,60. 87% of other 12 kinds HPV positive,while HPV16 positive with other 12 kinds accounted for 17. 39%. Among the 79 patients after 6-month follow-up,the dual-negative conversion rate（HPV+LCT）was 74. 68%（59/79）,with LCT and HPV negative rates reaching 92. 41%（73/79）and 74. 68%（59/79）,respectively. After 12-month follow-up,all patients achieved LCT negativity,29 patients with no documented lesion persistence or disease progression. Notably,patients aged <25 years exhibited the lowest postoperative HPV persistence rates between 6- to 12-month follow-up,whereas those aged 45-55 years demonstrated the highest persistence rates,frequently associated with HPV16 positivity or co-infection with other HPV subtypes. Conclusions CO₂ laser therapy significantly increases postoperative negative conversion rates for HPV and LCT. No lesion progression was observed in patients between 6- to 12-month follow-ups. The therapy also notably improves HPV clearance in younger patients. For patients with CIN2 who have fertility requirements and meet the indications,CO₂ laser therapy should be actively adopted to achieve greater health benefits.

Key words: cervical lesions, CO₂ laser therapy, human papilloma virus